QA Infection CLI

From CCMDB Wiki
Active?: active
Program: CC
Requestor: Critical Care QI Team
Collection start: 2009-08-22
Collection end:

Legacy project Changes Dec 31.18:

  *Anyone who has this problem and is discharged PRIOR to Jan 1.19,  code in TMP
  *Anyone who has this problem and is discharged AFTER Dec 31.18, code using ICD10

The Critical Care QI Team is monitoring Central Line Infections in the ICUs. This project is in collaboration with CCVMS which is a cross Canada ICU collaborative project.


will we still need to collect this in ICD10, since I think all the data now lives in the dx codes as well. I am holding off on implementing Query s tmp QAInf tmp no dx until resolved.

 There is no need to continue the QA infection VAP/CLI project since the dates are now collected for acquired ICD10. I will get the data from the L_ICD10 dx table for reporting. Thus the crosscheck queries are no longer needed except the one about LT 48HRS after admit. Also the instruction to email the QI Officer should continue.  Also the --JMojica 11:57, 2018 December 27

Data Collection Instructions

For all ICU patients:

If a patient
  • develops a Complication of Central Line Infection while in your unit
  • the CLR-BSI is newly acquired on your unit and not already reported at different unit
  • there is a positive culture (no positive culture, don't code)
  • Project: QAInf
  • Item: Central Line Infection
  • date_var: date (no time) positive blood culture was sent to micro lab.

Don't use TMP as notes

Please do not enter this TMP until you have actually confirmed a DX of CLI exists. Use the Notes field on you laptop as a reminder if needed.

Patient from other ICU with Central Line and possibly CLI

If Patient already has a CLR-BSI present on admission to your unit:

  • in the admitting diagnosis field, enter Central Line Infection.
  • do not enter into Tmp project.
  • if the patient is from another ICU in the city, email the collector at that site to check if CLR_BSI was captured as a complication at that site.


Sampling /Denominator

The denominator used to calculate CLBSI rate are the total patient days with central lines in the Central Line Tracking project before 2013 and the Central Venous Catheter at 2300 (TISS Item) from 2013 to present.

for which ICU do we report the CLI?

If the QA Infection CLI entry indicates a lab within 48 hours of arriving at a second (or more) ICU, it is reported for the previous ICU. If the sample is more than 48 hours after admission, or within 48 hours of discharge from an ICU to a ward, we report it for that ICU

  • Reported in Director/Manager quarterly reports.
  • separate report to Infection Control (Myrna Dyck), STB and Oaks.
    • August 2018 stopped sending separate report for CLI and VAP for Myra Dyck, infection control.


  • Start Date: Saturday August 22, 2009
  • End Date: NONE - Continued project with the CCVSM cross Canada Collaborative--TOstryzniuk 16:53, 4 October 2010 (CDT)

Cross checks

See QA Infection

Data Integrity Checks (SMW)

Query s tmp apostrophe in commentCCMDB.mdbimplemented
Query s tmp QAInf dx no tmpCCMDB.mdbretired
Query s tmp QAInf basicCCMDB.mdbretired
Query s tmp QAInf LT 48 hrs after admitCCMDB.mdbretired
Query s tmp QAInf tmp no dxCCMDB.mdbretired
NDC CLI AcqDX but NoCLI DateinTMPV2Centralized data front end.accdbimplemented
NDC CLI No AcqDX but CLI DateinTMPV2Centralized data front end.accdbimplemented

Related Articles

Related articles: